Get documents about "Email to
W
Document Sample
Email to: HR@new-industries.com We are an equal opportunity
employer, dedicated to a policy of
Mail to or Drop off: non-discrimination in employment
905 S. Neenah Ave on any basis including race, creed,
Sturgeon Bay, WI 54235 color, age, sex, religion, or
national origin.
EMPLOYMENT APPLICATION FORM NEW041 REV 3
APPLICANT INFORMATION
Last Name First M.I. Date
Street Address Apartment/Unit #
City State ZIP
Alt./Emergency
Phone
Phone #
Desired
Date Available Social Security No.
Salary
Position Applying for
Which shift(s) are
_____1st _____2nd _____3rd Which do you prefer?
you available?
Are you a citizen of the United States? YES NO Are you 18 yrs of age or older? YES NO
If so,
Have you ever applied to this company? YES NO
when?
If yes,
Have you ever been convicted of a felony? YES NO
explain
Do you have a valid WI driver’s license? YES NO
EDUCATION
High School Address
NO
From To Did you graduate? YES Degree
College Address
NO
From To Did you graduate? YES Degree
Other Address
NO
From To Did you graduate? YES Degree
REFERENCES
Please list three professional references.
Years
Full Name Relationship
known:
Company Phone ( )
Years
Full Name Relationship
Known:
Company Phone ( )
Years
Full Name Relationship
Known:
Company Phone ( )
Did an employee of N.E.W. refer you for this job? If yes, Please state his/her name:_____________________
If not, how did you know we were taking applications, news paper, radio or other:_______________________
PREVIOUS EMPLOYMENT (PLEASE BEGIN WITH MOST RECENT OR CURRENT JOB)
1.) Company Phone ( )
Job Title Supervisor
Salary $ Responsibilities:
From To Reason for Leaving
May we contact your previous supervisor for a reference? YES NO
2.) Company Phone ( )
Job Title Supervisor
Salary $ Responsibilities:
From To Reason for Leaving
May we contact your previous supervisor for a reference? YES NO
3.) Company Phone ( )
Job Title: Supervisor
Salary $ Responsibilities:
From To Reason for Leaving
May we contact your previous supervisor for a reference? YES NO
EXPERIENCE
List machines you
have operated:
Special Skills or Studies?
DISCLAIMER AND SIGNATURE
I certify that my answers are true and complete to the best of my knowledge.
If this application leads to employment, I understand that false or misleading information in my application or interview
may result in my release. I understand that this application will be active for a period of 60 days, after that time, if I wish to be considered for
employment I must submit a new application.
Drug Policy Agreement:
N.E.W. Industries, Inc. is committed to protecting the safety, health and well being of all employees as well as other individuals in our workplace and
has established a drug/alcohol-free workplace program. I understand that as a condition of employment I will be required to participate in pre-
employment, post-accident, reasonable suspicion and follow-up testing upon selection or request of management.
Signature Date
Office Use Only
Approving Manager: Date: Salary/Wage: Start Date:
